Workers' comp doesn't cover everyone; new measures filed

David Rittenhouse ensures internet service is running smoothly at Lake Region Electric Cooperative, which follows the rules for workers' compensation set by the Oklahoma Workers Compensation Commission.

When an employee is injured on the job and has to take a temporary leave of absence, it can create a financial hardship for everyone involved. That's why laws are in place to help workers pay for medical and living expenses, and at least theoretically, keep their position open for them when they're healthy enough to return.

Each state in the U.S. has its own set of rules and regulations for providing benefits to employees who suffer job-related injuries or illnesses. For years, the Oklahoma Workers' Compensation Court handled disputes. But in 2013, the Oklahoma Supreme Court upheld a law that put the Oklahoma Workers' Compensation Commission in charge of dealing with claims made by injured workers.

Employers in the state of Oklahoma are required to provide workers' compensation insurance for employees, but exceptions do apply for various scenarios. So business entities have to look at each individual situation and determine whether an employee qualifies for workers' comp.

"Each worker's compensation case is different. As a matter of policy, NSU does not comment about confidential personnel matters," Northeastern State University said in a released statement.

Employers can also opt out of the state insurance system and instead secure protection for employees by obtaining approval from the OWCC to be self-insured, or get the approval of Oklahoma Insurance Department to become a qualified employer.

There are reasons why an employee might not receive workers' compensation. According to Lake Region Electric Cooperative CEO Hamid Vahdatipour, LREC follows the guidance from the Oklahoma Workers' Compensation Commission. Employees injured outside of work are not covered under that umbrella.

"Medical insurance can cover the expenses, but there's no income assistance," said Vahdatipour.

The state has other exceptions for why a person would not be covered by workers' comp. For instance, agriculture or horticulture employees who work for an employer with less than $100,000 in payroll for agriculture or horticulture workers in the preceding calendar year are not considered "employees" under the Administrative Workers' Compensation Act, and are therefore not covered, according to the OWCC. Independent contractors; licensed real estate sale associates or brokers, paid on a commission basis; and those who work for an employer with five or fewer total employees, all of whom are related by blood or marriage to the employer, are not covered by workers' comp.

Federal government employees are not covered by state workers' compensation programs, but instead receive benefits through the Federal Employees Compensation Act.

The amount a worker is compensated is based on current wages and in accordance with the Commission's schedule that frames how much the person should be paid. For example, employers must provide temporary total disability benefits to an employee whom a doctor has determined is unable to perform his or her duties. If that person was put out of work before May 27, 2019, he or she receives 70 percent of the weekly wage, but the amount is capped at the state's average weekly wage. For those injured after May 28, 2019, their compensation is still 70 percent of their weekly wage, but capped at 100 percent of the state's average weekly wage.

Just as a physician must determine whether an employee is unfit to work, one must also determine whether the person can return to work. According to Vahdatipour, employees at LREC need a full work release to perform their current assigned jobs, and it must be signed by their medical providers. That is true of most businesses operating in Oklahoma covered under the law.

With the lawmakers currently in session at the Capitol, there are some proposals to alter the state workers' compensation system. For instance, one bill would make chiropractic care an allowable medical treatment. The state Chamber of Oklahoma, in its 2020 legislative agenda, said it would like to see legislators protect the reform of the compensation system that occurred in 2013, and it also supports changes to the medical fee schedule, which would control expenses while ensuring access to quality medical care.

The Daily Press several times asked Cherokee Nation officials about how workers' compensation functions for tribal entities, but the inquiry was not returned by press time.

Learn more

For more information on Oklahoma's workers' compensation system, visit ok.gov/wcc/.

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